Closed Intramedullary Nailing of Tibial Fractures in Elderly Patients

Abstract

Fracture of the tibia is a common injury. Its treatment has gone through "fashions" of conservative as opposed to operative treatment. 1-4 During the last decade the performance has again shifted to a more conservative approach: cast bracing. However, in the aged, operative methods that offer early mobilization should not be i g n~r e d .~.~ The authors have successfully employed closed intramedullary nailing as the method of choice for geriatric patients. Two typical case reports are presented. The indications, contraindications, complications, and advantages of this treatment modality are discussed. Reports of Two CasesCase 1. A 75-year-old man was injured in an automobile accident. On admission his right leg was severely deformed, without lacerations or peripheral neurovascular damage. Radiography of that leg showed a comminuted

The use of Poller screws as blocking screws in stabilising tibial fractures treated with small diameter intramedullary nails

“…These results appear to be superior to others reported for the stabilisation of metaphyseal fractures with intramedullary nails. 1,15 Ahlers and von Issendorf 11 analysed 386 fractures of the tibia; in 32 fractures of the proximal third there was an incidence of 59% of varusvalgus malalignment greater than or equal to 2° and in 138 fractures of the distal third 47% showed this deformity. In both proximal and distal groups, less than one-third had alignments less than 3° and one-quarter to one-third had varus-valgus deformities greater than 4°.…”